Three-dimensional analysis of pulmonary nodules: variability of semiautomated volume measurements between different versions of the same software.

PURPOSE: This study was done to evaluate the variability of semiautomated volume measurements of solid pulmonary nodules between two different versions of the same volumetric software. MATERIALS AND METHODS: The volumes of 100 solid intraparenchymal nodules (mean volume 88.10 mm(3); range 7.36-595.25 mm(3)) studied with the same multidetector computed tomography (MDCT) protocol were determined using two different versions of the same volumetric software (LungCARE 2006G and LungCARE 2007S). The 2006G version is based on a single-segmentation algorithm, whereas the newer version features two algorithms: SmallSizeNodule and AllSizeNodule. The results obtained with the 2006G version were compared with those of the 2007S version with the SmallSizeNodule algorithm, as recommended by the user manual. In addition, we compared the volumetric measurements obtained by the two different algorithms of the 2007S version. RESULTS: The 2006G version and the 2007S version with the SmallSizeNodule algorithm agreed in only two of 100 cases and showed a mean variability of 1.66% (range 0%-8.78%). A more significant volumetric discrepancy was observed between the two different algorithms of the 2007S version, with the AllSizeNodule algorithm providing on average larger volumes (mean variability 71.08%; range 6.02%-218.80%) than SmallSizeNodule. Volume discrepancies were more pronounced in the subgroups of smaller nodules in all comparisons. CONCLUSIONS: There is variability also in the results provided by different versions of the same volumetric software, and this may affect the calculation of the nodule-doubling time. Computer-aided assessment of the growth of lung nodules should always be performed using the same version of volumetric software and the same segmentation algorithm.

[Role of videofluorography in the study of esophageal motility disorders]. / Ruolo della videofluorografia nello studio dei disordini della motilità esofagea.

PURPOSE: To repropose the importance of videofluoroscopy in the study of esophageal motor disorders, comparing the radiologic and manometric results; the manometric results are considered the reference parameters. MATERIAL AND METHODS: From 1996 to 1999, 76 patients (42 males and 34 females), were studied first using manometry and then videofluoroscopy. The patients had symptoms like dysphagia, thoracic pain or both. The manometric study was performed with a perfusional system equipped with 6 tips (4 radial for the study of the esophageal sphincters and 2 placed longitudinally for the study of the esophageal peristalsis). With the patient in a supine position we analysed 5-10 deglutitions with 5 ml water bolus at 20-25 degrees C, administered using a graduated syringe. The radiologic study was performed with a remote-control digital television system, connected to a video recorder. Three 7.5 ml bolues of high density barium suspension (250% weight/volume) were injected orally in the upright position and other three were injected in the prone position following the passage from the oral cavity to the stomach. RESULTS: The comparison of the manometric and videofluoroscopic results suggests that the total sensitivity of the radiological study in the detection of esophageal motor disorders was 92%. In particular dynamic radiologic investigation diagnosed the normal esophageal functionality in 100% of the cases, nonspecific esophageal motility disorders in 89.6%, diffuse esophageal spasm in 100% of the cases, the presence of achalasia in 90%, whereas "nutcraker esophagus" only in 50%. Videofluoroscopy therefore showed high sensitivity in four groups of the five considered. It has some limitations in the diagnosis of initial achalasia, and is not sufficiently sensitive in the diagnosis of "nutcracker esophagus". CONCLUSIONS: Videofluoroscopy is a simple method which presents high sensitivity and specificity in the detection of motility disorders of the esophagus and could therefore be proposed as the first diagnostic method in patients with specific symptoms.